help please for this EBD case

[rsai]

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Case:
Alex
Alex is a 32 yearold grad student
who just moved to town. He has healthy teeth and gums. He recently had a prophylaxis completed last month at another office. Upon examination, you notice a mucosal lesion, which may be cancerous.You have been referring patients to the oral surgeon for biopsies of suspicious lesions, but recently read about Oral CDx, an oral brush biopsy.
You would like to know if this might be a good test to use for Alex.

PICO q:

In Alex case does oral brush biopsy is better compared to referring to oral surgeon for biopsy for better understanding of his mucosal lesion?? (this is my guess work).

can anyone post appropriate pico q for this case.

 

[Contach]

I think the question I would ask is: Is Oral CDx brush biopsy better than a traditional biopsy (incisional/excisional) for diagnosing neoplastic (pre-cancerous/cancerous) lesions?

Problem: diagnosis of suspicious, possible neoplastic lesions
Intervention: Oral CDx brush biopsy
Control: traditional biopsy
Outcome: specificity, sensitivity, positive predictive value, negative predictive value... any outcome assessment really

 

[145bluz]

After 25 years in practice ........Oral Cdx should be reserved for lesions that would not normally be biopsied. If a lesion is suspicious then it should be biopsied. Period.However, if it is a typically benign looking lesion-to the point where you probably would not biopsy, then that is a good situation for a brush bx. This gives you that added piece of mind for these rare cases. Example....a white lesion that you may believe is hyperkeratosis due to trauma from a tooth hitting a ridge. you would assume that it is due to the tooth hitting the ridge. So you probably would not BX..but to get a little more certainty you could perform the brush bx.

 

[145bluz]

Oh sorry...I thought P of PICO was population

P=healthy adult patients (probably without any traditional oral and pharyngeal carcinoma risk factores)

 

[rsai]

thank you all